I first learned of Tanya Selvaratnam’s The Big Lie: Motherhood, Feminism, and The Reality of the Biological Clock when she mentioned my book The Anti-Romantic Child in a lovely piece she wrote for the Huffington Post last January. She’d read my book when coping with a host of serious challenges– infertility, cancer, and a split from her husband-, and found solace in its honesty and its message that unexpected joy can come from extreme adversity. I then read Tanya’s book, and found it both an extraordinary memoir and a stirring call to arms for all women. Towards the end of her beautiful, brave book she writes “I hope this book touches people and inspires them to make changes in their world and in their lives.” It certainly did both those of things for me!

Here’s my conversation with the luminous and inspiring Tanya.

1. Tell me about the genesis of The Big Lie. Why did you write it and what do you hope to accomplish with it?

I got the idea for The Big Lie after my third miscarriage in fall 2011. Then, when I was forty, my doctor said, “The biggest factor is going to be your age.” After my first one at the age of thirty-seven, my doctor consoled me saying, “You have time.” I wondered, How do we define time? Less than three years had passed. I decided to write the book I felt I needed then, with the hope that it would help others.

Having been through my experiences, I want to make sure that other women are better prepared. I want them to have fertility facts at their fingertips and to think about their future fertility before it’s too late. I want women to know there are many ways to become a mother, and also that there are many ways to find fulfillment aside from being a mother. I want women to think carefully about why they should or shouldn’t pursue motherhood. I want them to be supported more in that pursuit by their partners, families, communities, doctors, insurance providers, and governments.
2. What is the reality of the biological clock and why do you think it’s been misrepresented by the media and by some in the medical profession?

Most people are aware that female fertility declines with age, but many don’t know what the odds of conception, miscarriage, and successful IVF treatment are at various ages. For example, at the age of fifteen, a woman has a 40 to 50 percent chance of conceiving naturally per cycle, but after age thirty-five, she has a 15 to 20 percent chance; and by the time she’s forty-five, she has a 3 to 5 percent chance.

It’s not that the information isn’t out there, but there are many confusing and misleading messages in the news about delaying motherhood. We see friends and celebrities at older ages having children, but we don’t know how much they might have struggled along the way. I believe it’s important to balance the optimistic scenarios with the heartbreaking ones.

As for the medical profession, it’s uneven which doctors proactively tell their patients about fertility statistics. There are many reasons for this variation. One is that OB/GYNs aren’t necessarily fertility experts. Another is that telling patients to think proactively about fertility might be viewed as an invasion of privacy.

When it comes to fertility clinics, again it’s uneven which ones make the statistics known and which ones don’t. These clinics are businesses, and they’re not adequately regulated. There’s a lot of money being made from keeping people in the dark about their chances of having a child through fertility treatment. I was lucky to have a fertility doctor who was straightforward with me. I remember her saying, “I could take your money and run, but here are your chances…” I decided not to freeze my eggs after 40 because the odds were so low of having a successful pregnancy.

With the media, a kind of telephone game can result from shoddy reporting and cherry-picked research. For example, the Washington Post recently covered a Boston University School of Medicine study, which showed that women who had children after age 33 without the use of drugs or fertility treatments were more likely to live longer than women who had their last child before the age of 30. Subsequently, the Daily Beast ran an article citing the Washington Post piece but left out the part about the women studied being a known fertile sample. The Beast piece also cited a statistic from Fertility and Sterility that 92 percent of 35- to 39-year-olds had at least one normal embryo to transfer after a single IVF cycle, but nowhere does the writer cite successful pregnancy rates through IVF for women in that age group (According to the CDC, it’s around 25% for women ages 35-37 and around 15-20% for women ages 38-40). The omissions are irresponsible and irrational. The writers are to blame, but so are the editors and media outlets.

Today, I received a letter from a stranger, a man who read my book and who with his wife had dealt with infertility. He made great suggestions, like legally mandated information sheets that include statistics about fertility, egg/sperm freezing, and assisted reproductive techniques. These sheets would be distributed to everyone by insurance companies, clinics, etc. He wrote that we need Right-to-Know laws with regard to fertility. I believe we can all be allies in advocating for measures like these that can correct the misrepresentations.

3. Tell us about the industry that has sprung up around IVF and egg freezing. What is the dark side of these ostensibly positive innovations?

When I was on the Melissa Harris-Perry Show in June to talk about the business of adding to families, Carmen Wong Ulrich, the personal finance expert, brought up that some IVF clinics and egg-freezing companies are behaving almost like the plastic surgery business. They don’t advise patients about the risks and exact statistics, and they don’t report their success rates accurately. Meanwhile, there’s a lot of money being made off of people thinking that science will give them a child. Globally, IVF treatment revenue is around $9 billion and that number is expected to exceed $21 billion by 2020.

In May, a representative from EggBanxx handed me a postcard that said, “Smart Women Freeze Their Eggs” and “Stop Your Biological Clock.” This is disturbingly false advertising. Egg freezing is expensive, has risks (I know a woman who developed serious OHSS, ovarian hyperstimulation syndrome), and can require many cycles to retrieve an adequate number of eggs. Also, approximately 80% of IVF cycles worldwide fail. Yes, there are beautiful success stories, but we have a right to know the odds. Knowledge is power.

Among the dark aspects are the gestational surrogacy industry in places like India (where poor women are lured into carrying a foreigner’s child) and sex selection in countries like Thailand (according to a report by Reuters this month, about 10,000 cycles at a cost of around $15,000 each were carried out last year in Bangkok for clients from around the world). A recent news report claimed that couples from the UK, where sex selection is illegal, have traveled to the US for this service, too. There needs to be a global monitoring body looking into these issues, especially since fertility tourism is a growing business. In the same way that there’s a Hague Adoption Convention on the Protection of Children and Cooperation in Respect of Inter-Country Adoption, there could be a convention on fertility treatments to ensure best practices.

4. What advice would you give college-age students about family-planning and careers? women in their mid-late 20s? 30s?

For college-age students:
1) Find out the fertility basics. Don’t expect someone (an educator or doctor) to tell them to you.
2) Take care of your body. What you do now could affect your chances of having a child.
3) Think about your goals. Do you want to be a parent? Under what circumstances? If you can’t have a child through natural delivery, would you consider adoption? Keep in mind that even if you might not want kids now, envision a time when you might change your mind. Are you prepared for if that moment comes?

For women in their mid-late 20s:
1) Pay more attention to all of the above.
2) Start exploring options for preserving your fertility, such as freezing your eggs, but keep in mind that this is not a guarantee of a successful pregnancy down the road and that it is expensive and physiologically taxing. If you are in a committed relationship, you could consider freezing embryos. If you want to have children with a partner, be open to a partner who will be a good parent. As a friend said to me, the criteria for a mate shouldn’t be simply whether the person “makes you breathless or makes you laugh.” When considering a serious commitment to a partner that involves having children, think and talk about your respective reproductive goals and parenting approaches.
3) Educate yourself by reading books such as Taking Charge of Your Fertility. You could also explore getting a fertility workup (including testing your AMH) with your ob/gyn.
4) Make sure you have good insurance, preferably a carrier that covers fertility treatments. Be aware that where you live and work is a major factor in your ability to afford having and raising children. For example, only fifteen states in America have mandated coverage for some forms of fertility treatments, and certain states have more accommodating parental-leave policies than others. You might want to consider moving or traveling to a different state or country that offers more affordable alternatives for fertility treatments and more family-friendly work environments.

For women in their 30s:
1) Pay even more attention to all of the above.
2) If you are above thirty-five years old and having trouble getting pregnant or have had a miscarriage, get yourself to a fertility specialist sooner than even your ob/gyn might advise.
3) If you are dealing with infertility and thinking of pursuing treatment, educate yourself. A good resource is Budgeting for Infertility.
4) If you have not had a biological child by the age of forty despite pursuing treatment, start considering other options for becoming a mother—for example, egg donation and surrogacy. Think especially about adoption.

5. What can gynecologists do and say all along the way to help women make well-considered, informed decisions about their fertility? What can parents tell their daughters?

There should be a chart of a woman’s fertility on the wall of every ob/gyn office. Spreading fertility awareness and making it specific (your chances at various ages of conceiving, miscarrying, having a successful fertility treatment, etc.) should definitely be part of ob/gyn protocol. It’s not an invasion of privacy; it can be empowering and enlightening to know the facts. It can also result in important discoveries about our health and our prospects for having a biological child. We’re told to start getting mammograms at 40 and colonoscopies at 50. Why can’t we be told to test our fertility in our late 20s/early 30s?

When my mother used to tell me to think about having a kid, it felt like an old-fashioned scold. I think there is no way around this feeling. But parents can give their daughters resources like Our Bodies Ourselves, Taking Charge of Your Fertility, and personal accounts like mine so that the daughters feel like they have agency in discovering the information themselves.

6. One of the things I like most about your wonderful book is your effort to reduce womens’ guilt and shame over miscarriage and infertility. How can we as women best support each other and create a safe space for sharing and solidarity on these most charged topics?

Thank you so much for bringing this up. One of my main objectives was to normalize the discourse around miscarriage and infertility. When I started sharing my story about miscarriage and infertility, I was amazed by how many, in fact, most women had a story to tell—either their own or a friend’s. Safe spaces can be forged on an intimate level between friends; they can be developed in larger groups, like in workplaces or through informal support groups. Any opportunity for women to speak truthfully is a valuable one.

Another objective I had with the book was to strip away the guilt women feel about the choices they have made and to encourage everyone to embrace the multiplicity of ways in which people live their lives, either with kids or without. There is so much snarkiness and casual brutality in this world, especially with instantaneous and often unretractable comments online. I hope everyone becomes more mindful and respectful of various experiences and differing opinions. I love George Saunders’s commencement speech that was then published as a book. He talked about more kindness as what’s necessary in our world.

We are constantly pitching ourselves against the expectations of others and of society, and this sets us up for disappointment or failure. We’re operating in a broken system, one that was forged largely by and for men. In many ways, we need to reinvent it. There’s a great campaign called MAKE IT WORK, co-directed by Vivien Labaton, which launched in June. Subsidized childcare, more guaranteed parental leave, tax credits for fertility treatments… these are just some of the measures that the government can adopt to make the choice to have a child more feasible. We can join together to advocate for change.

7. Your own marriage crumbled in large part because of your struggle with infertility. What advice would you give other couples in the thick of an infertility crisis?

I was blindsided by my husband’s departure, and the timing was scary, a few months after my surgery to remove the tumors and a few weeks before I was to resume fertility treatment. The health struggles had impacted our experience of each other, but every couple goes through such struggles at some point. Mine just came quickly after we married.

In the months that followed after where the book ended (with his leaving), I pieced together other things that were going on, and these discoveries helped me close the door. I still wake up feeling like I’ve been punched in the gut, but I’m thriving in many ways and hopeful. Abandonment can blow you open to a life that wouldn’t have been possible otherwise, as long as you keep your mind open and your friends around you. Kim Gordon is doing extraordinary work without Thurston Moore (I’m looking forward to reading her new book), so is Maria Shriver without Arnold Schwarzenegger.

I had started The Big Lie when I was very much together with my husband. When he left, I grappled with how much to reveal, but as I did more research on the impact of infertility on relationships, I realized it was important to address. Released earlier this year, a Danish study of 47,500 women showed that those who dealt with infertility and were unsuccessful in having a child after treatment were three times more likely to divorce or end cohabitation than women who dealt with infertility and were successful.

For couples dealing with infertility, I encourage them to talk to each other. Don’t be scared of the conversation. You can learn a lot about your partner and his/her values because of how he/she deals with these issues. Make sure you’re on the same page, and be there for each other. You are partners not adversaries. Perhaps seek outside help, even if it doesn’t feel like it’s in your nature to do so. There’s so much to gain from trying to work it out. But if you find that your visions for the future are truly diverging, then treat each other with the utmost care and kindness in breaking up. Don’t leave a trail of blood. You are both human beings.

8. How can we best support our family members and friends who are coping with a cancer diagnosis or cancer treatments? What’s the best and worst thing someone did or said to you when you were diagnosed and undergoing treatment?

Everyone deals with illness in a way that makes sense for themselves, and it’s hard to qualify best or worst. The worst thing is to drift away or do nothing. Even sending a simple note saying “I’m thinking of you” or “Let me know if there’s anything I can do” can make a huge difference. People’s characters show in the straits, and you can learn who’s a real friend in these situations. In my case, I was lucky in that most friends were there for me when I was down. I was also touched by people I didn’t know so well who reached out to me with such kindness. I felt everyone’s positive energy every step of the way, and I credit my friends with carrying me through not only the illness but also the divorce.

9. You have faced numerous hardships and crises with remarkable grace, courage, and resilience. What has helped you stay positive and balanced during this tumultuous and painful period in your life? (ie therapy, meditation, prayer, yoga, diet, etc).

Friends, art, and meditation, in that order. The first two kept me looking up and out. Meditation helped me look within. I started meditating two and a half years ago and still do so every day. There’s an app called Headspace, which is perfect for those wanting to get started on a practice. I think one of the next big cultural evolutions could be with regard to spirituality and mindfulness. More studies are coming out about meditation’s positive effects on our physiologies as well as psychologies. Unlikely proponents such as Dan Harris and Russell Simmons have written about the topic, and their books are entertaining reads as well.

10. How did your work in theater and your artistic passions help you cope with these crises in your life? More generally, how can art and an artistic bent or frame of mind help us to confront challenge, disappointment, loss?

The writer Suketu Mehta told me that an artist’s personal struggles can be “grist for the mill” for one’s art. In addition, I say “when life throws you lemons, make art.” I believe in turning adversity into action, and for me, making art is a form of action. I gravitate towards work, whether it’s producing a film, developing a theater piece, or writing a story, that represents me and what I believe, that the audience can have fun with, that can shed light on an important topic and possibly open the viewer’s eyes.

One of the jobs I have is working for Mera and Don Rubell, the great collectors of contemporary art. The advice they’ve given is “look for art that you don’t understand.” I try to apply this to the creation of art too, by tackling subjects that I don’t readily understand. Writing the book helped me grasp more what I was going through and helped me connect the dots within a larger picture. Whether it’s writing, painting, singing, acting, etc., expression through various forms can enable us to document and subvert the ruins and exuberance of life. When I look at art, I want to be inspired. Art, when it’s not simply created to sell a product or make a lot of money, can show us things that we otherwise might not see. It can teach us things about the world and ourselves.

Tanya Selvaratnam is a writer, a producer, an actor, and an activist based in New York City and Portland, OR. She was born in Sri Lanka and raised in Long Beach, CA. She is the author of The Big Lie: Motherhood, Feminism, and the Reality of the Biological Clock; and her work has appeared in Vogue, Bust, Paper, xoJane, Huffington Post, Pop and Politics, the Toronto Review, Art Basel Magazine, the Journal of Law and Politics, on Women’s eNews and CNN. Tanya has produced work by Gabri Christa, Chiara Clemente, Catherine Gund, Mickalene Thomas, Carrie Mae Weems, and Jed Weintrob; and toured around the world in shows by The Wooster Group and The Builders Association. She has been a fellow at Yaddo and Blue Mountain Center. Tanya received her B.A. and M.A. in Chinese language and history from Harvard University.

Thank you for your thoughts. Wonderful interview. Yes – I agree the word needs to be shared about fertility issues.

rockerred

Quite deep into resources, frame of mind. But nothing to suggest that parenthood just might be pursued through other means. The effect, though certainly unintentional, is to advance the age-old stigma felt by adoptive children. Would suggest a preamble to qualify this otherwise-useful column.